Heakthcare Strategies Decision Making Tools Essay

Heakthcare Strategies Decision Making Tools - Essay Example 1. We have to develop a policy statement for the contingency plan. For us to have a successful policy, the policy should be able to provide the guidance and the authority that is useful in the realization of the contingency plan. The policy statement contains all the needs that the healthcare will need in order to be effective. For the surgical centre in this step we have to identify all the things that will be needed by the healthcare this may include the surgical equipments, the staffing of the surgical centre and the tools that are needed to be able to complete the surgical centre. We also have to identify the roles of different stakeholders and how these stakeholders take part in the contingency process (Donaldson, 1992). 2. The second step is the impact assessment. This is where the feasibility test is done. In impact assessment, we have to check and know if it is possible to create the program at hand. Do we have all the resources that are necessary for the realization of the g ive goals or are we risking failure and loss due to the implementation of the program. For the surgical centre here, I have to check if it is possible to create this surgical centre and the funds that are available for its creation. ... 3. Recovery strategies. This is effective strategies that are put in place in case of disruption, the operations of the program can easily be normalized. When this is done we have to take the full range of all the possible incidences that can occur during the program. Some of the strategies that we have to look at for this particular project include (Broadbent, 1979). 4. Creation of contingency strategies. These strategies are effective in case the system is lost and we need to recover it. The following are some of the strategies that I have put in place for the surgical centre (Broadbent, 1979). All this strategies have to be implemented step by step so as to ensure that none is skipped as they are all useful in the realization of a good plan in case of any emergencies. Backup failure. We have to backup all the data that will be used for this particular project elsewhere in another hard disk or another computer so that incase of any loss of data in one computer, then it can be recov ered from the backup computers. Alternative sites. Sometimes a situation might arise that the location of the surgical centre have to change, in this case, we have to have an alternative site for the setting up of the surgical centre in case the current place is unavailable. Renewal of equipment. We have to have solutions for events when equipments may be lost due to theft or even any careless lost. The main equipments here will include surgical equipments that are useful in the industry. Roles and responsibility incase of an emergency. For every emergency, we have to state the roles of the different stakeholders to try and manage the situation. When this is done, we have to look at all the factors that are listed before

The Biopsychosocial Model Health And Social Care Essay

The Biopsychosocial Model Health And Social Care Essay In the preceding paragraphs many theoretical models were put forward, but it is now desirable to introduce a holistic model of causation, one that is more naturalistic than the simple linear reductionist models (Borrell-Carrià ³ et al., 2004). A comprehensive literature search showed that the most common and widely accepted holistic framework for treatment and rehabilitation is the biopsychosocial model. The popularity of this model can be seen by the frequency of its occurrence in online sources. A preliminary assessment of the biopsychosocial model was conducted using the Medline database, using the term biopsychosocial in the topics field. It is well recognised that use of the term biopsychosocial does not necessarily indicate an adoption of the biopsychosocial model, but at a minimum, it does reflect a recognition of the perspective (Suls Rothman, 2004). Figure 1.5: Frequency of citation of the term biopsychosocial using the Medline database. 4.1 The Biopsychosocial Model One of the famous landmarks articles, published almost thirty years ago by Engle (1977), questioned the biomedical interventions used in both psychiatry and medicine, and warned of a crisis in the biomedical paradigm (Alonso, 2004). Engle (1977) argued that a true medical approach should consider: (1) the patient; (2) the healthcare system; (3) the social context of the patients life; and (4) the psychological context (Mrdjenovich et al., 2004; Pereira Smith, 2005). The main proposition of the biopsychosocial model is that treatment interventions should be an interlinked system covering multiple dimensions (i.e. diagnostic and causative variables), taking into account biological, social, psychological and macro (e.g. socioeconomic status, cultural, ethnic) issues (Figure 1.6) (Burton et al., 2008). Any defect in one part of the system will affect another part of the system (Keefe et al., 2002). For instance, deterioration of a patient condition (biological effect) can negatively aff ect patients` emotional states increasing stress and anxiety level (psychological effect) affecting his/ her ability to work or perform his/her daily routine activities (social effect), which will then, subsequently, increase pain and/or disability levels (Keefe et al., 2002). Figure 1.6: A pictorial illustration of the biopsychosocial model. Adapted from Finlay (2009). The biopsychosocial model accentuate the importance of interacting and understanding the patient as a unique individual taking onto consideration their belief system in a moderate way that neither concentrate on the biomedical aspects or psychosocial aspects but rather illustrate their relationship together (Jones et al., 2002). In comparison between the biopsychosocial model and the earlier discussed models, it can be seen that the biopsychosocial model posits a much complex, multidimensional and broader approach of clinical care (Hadjistavropoulos Craig, 2004). Engles new paradigm has often been seen as a radical departure for medicine (Salmon Hall, 2003, p.1972). However, Lambert et al. (1997) stated that although the biopsychosocial model is a new approach, it is still conservative. This assessment was based on several perspectives proposed by the model. First, by underlying the need for good clinical decisions to respond to the eccentricities of each individual patient, it re-affirms the patients role, self identity and professional independence (Armstrong, 2002; Salmon Hall, 2003). Secondly, the model extends the responsibility of medical care to go beyond biological complications and encompass non-medical treatments as well (Baer, 1989). Physicians are required to connect with their patients in a relationship that involves not only the patients complaints and symptoms, but also their personalities and psychosocial lives (Salmon Hall, 2003). Conversely, patients are expected to be prepared to respond to the physicians and bring about the required changes in their lives to prevent and/or manage their illness (Salmon Hall, 2003). However, one of the issues that has been discussed in the literature is whether the concepts of the doctor-patient relationship and patient-centredness can affect and threaten the doctors authority. However, if the requirements for patient-centredness and a doctor-patient relationship are applied in a moderate and professional way, they do not threaten either the doctors authority or their responsibility, especially since physicians maintain their authority by virtue of their specialist knowledge and their responsibility for an accurate diagnosis and appropriate treatment (Salmon Hall, 2003). Taking on the considerations mentioned in this section lead to a perceived need for a study to determine the current methods followed in managing lower limb injuries (either in elective or emergency cases) and whether the biopsychosocial model is a better approach of treatment. 4.1.1 To what extent have the medical establishment and different research fields adopted the biopsychosocial model? The biopsychosocial model has been widely adopted and promoted in different domains, including medical schools, major medical organisations, social work departments, public health, counselling, and some fields of psychology (Kaplan Coogan, 2005). For example, the WHOs International Classification of Functioning, Disability and Health (ICF), which is a global framework of disability and rehabilitation, is based on the biopsychosocial model (WHO, 2001). Dowrick et al. (1996) conducted a study to explore whether the biopsychosocial model is based on rhetoric or reality. A semi-structured postal questionnaire was sent to 494 principal general practitioners. The questionnaire sought the practitioners views about what they believed to be relevant and appropriate to a practitioners skills and knowledge in general medical practice, and investigated whether these views are consistent with the biopsychosocial model. Only 41% (207) of the sample responded to the questionnaire, which is considered to be a low response rate (Church et al., 2001). The results showed that general practitioners embrace the view that physicians should incorporate a biopsychological model, rather than a biopsychosocial model, in their general medical practice. However, the results cannot be generalised because the study was conducted exclusively on members of a specific organisation. Therefore, the results can only be only applied to the specific population describ ed in the study. Similarly, Alonso (2004) also investigated the extent to which the biopsychosocial concept has been adopted by medical researchers. Using the Medline database, Alonso examined published articles in the period 1978-1982 (period a) and the period 1996-2000 (period b). Period a was selected because it covers the first five years since Engels conceptualised his new model, and the second period (period b) was determined by the date of Alonsos study (covering the five years before the study). The findings of the previous study showed that the conceptualisation of health in medical research, as characterised in articles written within the past two decades, has not changed. In other words, physicians are still reluctant to incorporate the biopsychosocial model, and often focus solely on traditional methods of treatment. Other studies (Dowrick et al., 1996; Cohen et al., 2000; Alonso, 2004; Kaplan Coogan, 2005) also concur with the findings of Alonsos original study, and conclude that the bi opsychosocial model has not been fully integrated into actual medical practice. Conversely, in an evaluation of published articles between the years 1977-1987 and 1988-1998, Hwu et al. (2001) found a considerable spread of medical research articles that did include social and psychological aspects in their definitions of health and medical care. In addition, a literature search also shows that several behavioural, medical and psychological phenomena have adopted the biopsychosocial concept (Kaplan Coogan, 2005), in areas such as schizophrenia (Kotsiubinskii, 2002; Schwartz, 2000), chronic fatigue (Johnson, 1998), antisocial behaviour (Dodge Petit, 2003), gastrointestinal illness (Drossman,1998), spinal cord injury (Mathew et al., 2001), and pain management (Truchon, 2001; Covic et al., 2003). Clearly, there are conflicting findings in the existing literature regarding the extent to which the biopsychosocial model has been integrated into the medical domain, indicating a need for future research. 4.1.2 Application of the biopsychosocial model in rehabilitation Several authors have argued that there is a considerable gap between the introduction of a new or revised model and the application of the proposed model in clinical practice (Linton, 1998; Muncey, 2000; Jones et al., 2002). The challenging factors surrounding changes in clinical practice have been reviewed by Muncey (2000), two of which are associated with physicians decision-making skills and knowledge. In addition, physicians reluctance, in some cases, to integrate new models into their clinical practice should also be taken into consideration (Silagy, 1998; Jones et al., 2002). Furthermore, because the current medical literature is often introduced at a basic scientific level, it is complicated for non-researchers to understand and transfer new models and theories to clinical settings (Jones et al., 2002). Jones et al. (2002) stated that in order to achieve successful application of a new pattern of behaviour and practice thinking, two elements are required. These are reflective, critical clinical reasoning (i.e. the decision-making process), and a suitable organization of knowledge in which the new model can be implemented. The significance of the biopsychosocial model is based on its capability to show the multitude of interactions between its elements (Jones et al., 2002). in addition, every individual element can then be further explored. However, this means that physicians need to further develop their clinical practice skills in terms of patient assessment and management, either physically or in terms of other factors that contribute to their patient`s illness (Jones et al., 2002). One of the elements that should be considered in the application of the biopsychosocial model is diagnostic reasoning, which mainly depends on the application of the scientific paradigm (or the empirico-analytical model) for decision-making and validation. This form of reasoning attempts to identify and test hypotheses relating to the nature of psychological and physical impairments and their functional disabilities (Jones et al., 2002). Narrative reasoning is another form of reasoning which is used to understand the patients own experience with their pain and illness (Mattingly, 1994; Jones et al., 2002). However, although this sounds like a simple method, in fact it is far more challenging than simply listening to patients own stories (Jones et al., 2002). Finally, it is essential to highlight the fact that the biopsychosocial approach is not only concerned with curing pathological defects, but also with helping people to regain their normal life activities (Burton et al., 2008). In addition, it is acknowledged that there may be a certain amount of reluctance regarding the adoption of the biopsychosocial model because of the hurdles in the way of its clinical application (Burton et al., 2008). Changing the way in which injuries are managed in clinical settings will require further investigation, since little attention has been paid towards identifying the current methods that are used to manage lower limb injuries (either in emergency or elective settings) and whether the biopsychosocial model is a better approach in managing such injuries. From the findings and the studies presented in this literature review, it can be concluded and hypothesised that enough clinical evidence exists to show that the biopsychosocial model is a better approach to managing lower limb injuries. On the other hand, the literature does not answer the basic question to whether the surgery is elective or emergency make a difference to the patient experience after injury, which necessitate the need for further investigate. 5.0 Conclusion Little attention has been given to the patients experience after lower limb surgery for example, comparing and contrasting the experiences of patients who have had elective or emergency surgeries, exploring physical, social and psychological aspects, and looking at whether methods of treatment and follow-ups are applied differently between elective and emergency surgeries. In addition, although various studies had focused on how the physical, social and psychological factors interlink together, no previous study has investigated the outcome of the application of the biopsychosocial model in managing patients after lower limb surgery as a result of injury, compared to those who were treated using other treatment approaches. Therefore, to address these issues, this study aims to explore and report the patients experience of clinical care of lower limb injury after surgery, comparing and contrasting the experiences of patients who have had elective or emergency surgeries, and investigating whether the biopsychosocial model is a better treatment approach for the management of lower limb injuries than other approaches. Thus, the current study is based on the following research questions: 6.0 Research question Primary research question: What are the differences between patients experiences and clinical approaches after elective lower limb surgery as a result of injury, compared with patients experiences after emergency lower limb surgery as a result of injury? Secondary research question: If a difference exists among patients experiences and clinical approaches between elective and emergency lower limb surgeries as a result of injury, how does this difference related to the current care pathway including the biopsychosocial model? 6.1 Aims and objectives The aim of this study is to develop a better understanding of patients experiences after a lower limb injury that is severe enough to necessitate surgery, and to compare medical services (after lower limb surgery) provided in emergency settings vs. elective settings. In addition, the study aims to investigate the efficiency of current methods of treatment and compare them with treatment methods derived from a biopsychosocial approach. Understanding the experience of lower limb injury from the patients perspective is essential for providing guidelines for appropriate and efficient medical services, and in the prevention of future complications for the patient. In addition, such an understanding will form a reference for future research studies. The objectives of this study are to explore and report: The difference in patients experiences of medical services for lower limb surgery provided in emergency settings and elective settings. Whether the current biomedical approach to managing lower limb injuries is efficient enough from the patients perspective. The importance of psychosocial factors for a patient with lower limb injury. The importance of implementing treatment methods derived from a biopsychosocial model approach. 6.2 Statement of null hypotheses The research is based on three null hypotheses: The primary null hypothesis states that there will be no difference in patients experiences in emergency and elective surgery settings for patients with lower limb injuries. The secondary null hypothesis states that there will be no difference between elective and emergency lower limb surgeries as a result of injury, and hence it does not relate to the current care pathway including the biopsychosocial model.

Psycho-Social Theory and Nursing Care Essay -- Nursing Healthcare

Owing to significant research into the relationship between physical, mental and social conditions, an awareness and understanding of psycho-social aspects in health care is vital (Walker et al, 2007). Those aspects are particularly important in nursing care, where an individual should be considered as the entire person with a need for physical, psychological, social, emotional, intellectual and even spiritual wellbeing (Holland et al, 2008). This essay will address psycho-social theory of health beliefs and attitudes in relation to nursing care. The essay will begin by considering how health beliefs lead to health behaviours. It will then discuss how theoretical models contribute to nursing care and their usefulness and importance in applying the theory to nurse patients. As the largest force in health care, nursing profession is considered to be in a unique position to facilitate health promotion and disease prevention. Nurses spend considerably more time with patients in comparison to other healthcare professionals and as such, they assist patients in managing their own health. The fundamental requirement in providing this care is to ensure that individuals remain as independent as possible through encouragement and empowerment. There are number of factors to be considered in delivering this care effectively. In view of cultural, socio-economic and educational diversity amongst us, it is difficult to define â€Å"health† or indeed â€Å"illness†. As our perceptions differ, so do our interpretations and possible meanings of those words. The World Health Organisation (WHO), 1948, states that â€Å"Health is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity†. Although posit ive, the def... ...arlow. Shaw, C., Brittain, K., Tansey, R. & Williams K. (2008) How people decide to seek health care: A qualitative study. International Journal of Nursing Studies, 45 (10), 1516-1524. Sully, P., & Dallas, J. (2005) Essential Communication Skills for Nursing. Edinburgh: Elsevier Mosby. Walker, J., Payne, S., Smith, P., Jarrett, N. (2007) Psychology for Nursing and the Caring Professions. 3rd. ed. Glasgow: McGraw Hill. World Health Organisation (1948) â€Å"WHO Definition of Health - Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948† at http://www.who.int/about/definition/en/print.html. (accessed 02 December 2010).

Creating a Democratic School Essay

The current educational set up is based on a curriculum that is centered on adults and their feelings towards educating their young’s or the younger generation. Most often, their sentiments, aspirations and aims do not coincide with what the younger generation wants or feels like doing by creating or providing a curriculum which, though sometimes child centered, muzzle with the individual freedom of the young learners. There is a need to change the present set up of the school in order to effectively respond to the demands of globalization by giving back to the learners and to their parents the needed voice regarding the things they want to learn or do in school. Deborah Meier (2005) opined that the changes in school structures should be pursued by a convinced and involved faculty who believes that there is a need to change the system although being involved is not an easy task but a very taxing one. The Herculean task involves changing an embedded lifetime habit on the way schools should be run and the way parents and students expect education to be delivered. This task should be performed by all the participants in a climate of self-governance. According to Garrison (2003) John Dewey defined education in a technical sense as the â€Å"reconstruction or reorganization of experience which adds to the meaning of experience and which increases the ability to direct the course of subsequent experience† (p. 527) This paper will examine how to create a democratic school and the factors involved in it as well as the modalities of its existence. Components of a Democratic School Democracy As the central tenet of social and political relations, democracy is American’s basis of self governance (Beane & Apple, 2002). As a tool of measuring wisdom and the worth of social policies as well as any shift in the current paradigm, democracy is the ethical anchor that holds the system of government in place. According to Beane and Apple (2002) it is through â€Å"democracy† that Americans measure their political progress and trade status with the other countries. People were taught that democracy is working in various ways of political governance’s social dimensions involving the consent of the people and the equal opportunities given to them. Beane and Apple (2002, p 6-7) added that â€Å"[l]ess explicitly taught were the conditions on which a democracy depends, the foundations of democratic way of life. The stated conditions and extensions even extend to education, to wit: [t]he open flow of ideas, regardless of their popularity, that enable people to be as fully informed as possible; [f]aith in the individual and collective capacity of people to create possibilities for resolving problems; [t]he use of critical reflection and analysis to evaluate ideas, problems, and policies; [c]oncern for the welfare of others and â€Å"the common good;† [c]oncern for the dignity and rights of individuals and minorities; [a]n understanding that democracy is not so much an ‘ideal† to be pursued as an â€Å"idealized† set of values that we must live and must guide our life as a people; and [t]he organization of social institutions to promote and extend the democratic way of life. † In Citing Dewey’s works, Beane and Apple (2002) theorizes that in order for the people to maintain its security and the blessing of democracy in their daily lives, they should be gi ven an opportunity of knowing the real meaning of life and how or where it might led to. Though with objections, followers of democratic ways in school firmly believed that the democratic way of life hinges on the learning opportunities and its dimensions on how to lead it. For them the school has the moral obligation to educate the students and allow them to experience and taste the true meaning of democracy because it is not solely for the benefit of the adults but for the young generation as well. The democratic system’s leaders fully consider the consequences of their visions. Having a democratic school is not purely actively involving the young but extend to the establishment of a democratic place where democratic ideals flourishes to the various adult’s roles played in schools. Thus, various educational partners and stakeholders such as teachers, school leaders, parents, community activist, and other citizens should be fully informed about their critical role and participation in enacting school policies and guidelines as well as programs for maximum utilization of the young people. There are painful contradictions and tensions in establishing a democratic school. These factors revealed that enjoying the fruits of democracy in life is always a privilege but coupled with a struggle. But above and beyond these struggles, creating a democratic school is a hope for a possibility for professional educators and citizens to work together in creating a sound and flexible but enjoyable democratic schools which will cater to the ideals of the common good of the whole community (Beane & Apple, 2002). The Democratic School’s Structure A democratic school’s structure provides a venue for an active participation of all stakeholders especially those who are directly involved in the school management, including young people, have the right to participate in the decision making process, including professional educators, young people, their parents, and other school community members. The democratic planning at the school and classroom level is a genuine attempt to honor the people’s right to participate in the decision making process affecting their lives as it adheres to the democratic values (Beane & Apple, 2002). The right of the participants to be heard is coupled with responsibility as it opens a door on how the opposing views will fit into the delicate equation of balancing special personal interest with a larger common good of the democratic community (Beane & Apple, 2002). The learning activities in a democratic school are characterized by cooperation and collaboration rather than competition among the young people as it emphasizes structural equity of the young people’s right of access to all programs in the school as well as the outcomes of its school values. This structural equity assures the public and the entire stakeholders that the school has no institutional barriers against the young people by doing away with the school’s eliminating tracking, biased testing, and providing equal opportunities to everyone regardless of race, gender, and socioeconomic status. Likewise, the school structure adheres to the improvement of school climate and enhances student self-esteem as well as reducing social inequities resulting to the total overhauling the immediate environment that affects them. What distinguished democratic schools from the other kinds of progressive schools—humanistic or child centered school even if in both or many ways shared the same visions with the democratic school’s visions, it extends beyond by improving the school climate or enhancing student’s self-esteem. Democratic educators seek not simply to lessen the harshness of social inequities in school, but to improve the environment and the living conditions that affects them. Democratic Curriculum The curriculum of the democratic school allows its participants’ views to be heard as an educator in this system has the moral responsibility to help young people develop their ideas by actually voicing them for the benefit and critic of the others. The curriculum moves beyond selective norm of the dominant culture’s endorsed knowledge and meaning to a wider range of views and voices as it considers not just adults perception but also the youth’s question about themselves and their worlds by inviting young people to assume the active role in the search of meaning to their world rather than just being mere spectators only(Beane & Apple, 2002, p 13). The democratic way of life is seeking dynamic paths by which the values of democracy extend and expands. The curriculum developed both the intelligent and reflective component of a child or leaner in solving problems, events, and issues that crop up in the course of their collective lives. For Beane and Apple (2002), the curriculum is a discipline of knowledge and not simply categories of educated children to absorb and accumulate but a source of insight and information that will serve as living lenses through which to look at those issues that confront society. Thus, a democratic curriculum is â€Å"helping the students become knowledgeable and skilled in many ways, including those required by gatekeepers of socio-economic access. â€Å"Simply, democratic educators live with constant tension of seeking a more significant education for young people while still attending to the knowledge and skills expected by powerful educational forces whose interest are anything but democratic† (Beane and Apple, 2002, p 16-17). Finally, as a mover of change, a teacher in a democratic community has the right to have their voices be counted in curriculum planning and development. This is in line with the idea that since they are the one’s who interact with the child, they should be heard the most for they are more knowledgeable of the child’s nature. Beane and Apple (2002) revealed that the current set up in a non democratic school is that all curriculum planning and design is located at or centralized in the state or district offices of education. Tensions Inherent In the Concept There are factors that need to be resolved and look into in order to have a fuller understanding of the open tensions inherent in any democratic school. Community is a number one area and source of tensions undermining this system’s success. In order for any school system to be successful, complete overhaul of the community should be given a paramount importance and preferential attention in order to act as a democratic school’s partner in creating a democratic youth’s institution (Furman & Starrat, 2002). Furman and Starratt’s (2002, p. 106) give the following â€Å"nature or character of a democratic community. This concept was derived from Dewey’s progressivism. The following: [d]emocratic community is based on open inquiry, the full and free interplay of ideas as suggested by Dewey; [d]emocratic community members work for the common good; [i]n a democratic community, the rights of all, including the less powerful, are respected; and [c]reating democratic community in schools is a systemic challenge, involving structures, process and curriculum. † Problematizing Community Furman & Starrat’s study revealed the two â€Å"prevailing attitudes for better understanding the community in education. These are: the understanding of the anachronistic attitudes of community in education in assuming that social conditions underpinning earlier theories of community can be recreated in contemporary schools and societies; and that the rendition of community in education tend to create an impression of the school as an isolated, â€Å"stand alone† community, in which heroic educators strive for cohesion amidst a sea of chaotic outside forces that threaten the school’s educational; values† (2002, p. 108-109). First, exercising difference and otherness concept in community building provides a matrix that accepts differences with respect to justice and appreciation and peaceful cooperation with differences. Second, the prevailing attitudes provide for a sense of interconnectedness and cultural capital exchange between community and schools needs to be recognized and nurtured (Furman & Starrat, 2002). Above and beyond these two issues is the fact that for a democratic school to succeed â€Å"community† needs to be redefined and this redefinition will then form part of the idea of a democratic community. For Furman & Starratt, the community’s new understanding â€Å"must be based on acceptance and celebration of difference rather than a futile and nostalgic striving for sameness and homogeneity which will focus on the integral linkages between the school, the surrounding community, and the larger global community rather on the isolated community within the school walls. The key to answer this novel undertaking is to understand that community works on interdependence and the common good† (2002, p. 110-111). Finally, the diversified school population of a democratic community in school, provides for an interdependent relationship in order to achieve the common good of the school; â€Å"that the school and surrounding community are also interdependent—culturally and economically—with the school being a key contributor to the community’s cultural capital and common good; and that ultimately, all people, and the school communities to which that belong are interdependent and interconnected in contributing to the common good of human kind† (Furman & Starratt, 2002, p. 110-111). Problematizing Democracy As in the case of the community, the school’s democratic practices have two dimensional issues needed for a democratic school system’s consideration. The first issue is that the school’s democratic practice is minimal as the freedom of choice and expressions are seldom experienced in schools; and that a democratic tenets emphasizes the individual freedom to pursue its self-interest, â€Å"with citizen participation in government reduced to electing representatives who will promote policies that serve the pursuit of that self-interest† (Furman & Starratt, 2002, p. 110-111). The present issue led to democracy’s reconceptualization as there is a pressing need for cross-cultural, cross-national dialogue and understanding of common good in school. Thus, â€Å"democracy needs to incorporate the values of post modern liberalism, or civic republicanism, or deep democracy and civic participation. These values are: [t]he worth and dignity of individuals and the value of their participation; [r]everence for free and open inquiry and critique; [t]he responsibility of individuals to participate in open inquiry, collective choices and actions in the interest of the common good; and [t]he recognition that post modern democratic participation transcends understanding of democratic principles associated with specific nation-states. † (Furman & Starratt, 2002, p. 111-112). Democratic Minimalism in Schools Furham and Starratt (2002) cited Maxcy’s 1995 study which revealed that â€Å"American public education has been dominated by democratic ‘minimalism’ both within the school and in regard to local control and governance because the scope of democratic decisions making and freedom of choice and expression has been extremely narrow. † Minimalism is prevalent in American public school due to educator’s fear that democratic practices carries with it some risk like chaos and loss of control once democracy is released to the classrooms. Thus, there is a need to conform with the hierarchical structure in place regarding decision making on the various aspects of learning (p. 112). Finally, as a community of differences, democratic community’s difference is recognizing the interdependence and the common good, as the local and global glue. Also, the democratic community is â€Å"informed by a deep or thick version of democratic participation in which all citizens have a respected voice, and communal action is determined through high levels participation in free and open inquiry† (p. 112-113). Democratic Participation’s Process In a democratic school the structures and procedures allow all school’s members to participate and have a respected voice in decision making and policies affecting them. Though recognizing school’s interdependence, surrounding community, and the assets that any community offers, these structures and procedures includes community members and is open to community-initiated participation (Furman & Starratt, 2002, p. 117-118). There is a collaborative planning by the student and teachers in reaching decision that respond to their concerns, aspirations, and interests. In Brodhagen’s (2002) article entitled â€Å"The situation made us special† wrote that at the start of her class they made a written constitution (p. 87) that will serve as their guide. This constituent embodies the pledge of every participant and signatories that they will observe respect for individual differences in opinions and individuality as well as enjoined themselves into formation of collaborative learning experiences, listening to others and resolving conflicts which may divide them in the future. Also in the same study, Brodhagen’ students were involved in curriculum planning (p. 87-89) as they try to unravel the mysteries of their individual differences and their unique world they live in. In the case Rosenstock & Steinberg’s (2002) paper entitled â€Å"Beyond the shop: Reinventing vocational education† revealed that in her case they have a common planning time wherein the teachers and counselor who signed for the program sits together and plan, review revise, and proposed curriculum activities and most especially to get to know each other as well as they explore collaborative work (p. 49). For Furham and Starratt (2002) the student and teacher’s activities planning are guided by a four-stage â€Å"process of democratic deliberations: information sharing; reaction; ideas and strategy developments; and debriefing. † The meeting held is not confined only with the â€Å"instructional/curricular decision but also to varied subject matters that concerns the participants. † The above process may be used by the teachers in their meeting with their fellow educators. â€Å"Significance parent involvement and broad based community participation also need to be nurture[d] through creative ideas in regard to shared governance, communication and meeting structures that are equitable and inviting and promot[ing] understanding across groups and individuals who might clash in their values. Democratic participation requires more than forums. It requires the ability to listen, understand, empathize, negotiate, speak, debate and resolve conflicts in a spirit of interdependence and working for the common good† (p. 118). The Morality of the System There is also a moral dimension that is a ground for conflict in a democratic school. Furham & Starratt (2002) provided a moral dimension of a democratic community. The following: â€Å"[a] social morality that values sociality itself, that is, that values coming together in the communicative spaces under which dialogue can occur in the interest of the common good; [a] reverence for open inquiry and critique within these common space, in pursuit of the common good; [a] respect for individuals and for the assets they bring to communities, with a view toward celebrating difference; and [a] sense of responsibility that acknowledges the interdependence of all in achieving the common good† (p. 120). School educators in a democratic community promotes the above mentioned values through modeling and discussions pertaining to behaviors such as respect, sociality, empathy, compassion, acceptance of difference, forgiveness, generosity, and teamwork. The older student could be a great model for their younger school mates helping them to develop the basic habits of caring for fellow members of the school community. The interdependence will be the mor al foundation of the school as a community (Furham & Starratt, 2002, p. 121). Curriculum and Instruction The processual and moral dimension of a democratic school is the basis of democratic school’s curriculum which is characterized by openness to multiple ideas and sources of information and to critique this information. â€Å"A democratic curriculum would be based on interdependence as a theme. History, science, and government’s presentation in a democratic school, the curriculum would help students understand the fundamental ecological interconnectedness of human life across culture and nature† (Furham & Starratt, 2002, p. 120-121). The fundamental approach in a democratic community is the process of democratic deliberation. In a democratic community, classroom management had prior discussion among class members and consensus about appropriate behavior and sanction for violations. Furham & Starratt’s (2002) study is consistent with the Brodhagen (2002) and Rosenstock & Steinberg’s (2002) paper whish espoused collaborative learning atmosphere in creating curriculum and design. For Furham & Starratt’s (2002) ‘peer teaching and coaching would become more common. Classroom debates of differing perspectives would teach respect for different points of view as well as provide for learning how to conduct such debates in public following rules of civility and respect, as well as logic and evidence gathering [which the ] systemic nature and challenges of enacting democratic community in schools† (p. 122-123). Leadership Processes Leadership in Democratic community in Schools After establishing a dynamic and democratic curriculum based on the fundamental tenets of democratic practices in the community, leadership is needed to fill the void that will implement the curriculum and run the democratic community in school In Furham & Starratt’s erudition of a democratic school entitled â€Å"Leadership for Democratic Community in School† describes the role of leadership in a democratic community with emphasis on school. Furham & Starratt describes the leadership as being democratic and communal and is not reposed on any specific administrative function â€Å"but on a communal responsibility shared by all participants at a particular school grounds. † As processual, democratic community’s leadership practices attends to the creation and maintenance of democratic process and structures that nurtures thinking aloud together; thus, the leadership practice is both intentional and opportunistic. All decisions and issues affecting the school community and its members is open to democratic deliberations. Thus, leaders need to attend with sensitivity in mind to the continuous flow of concerns and `the opportunity for decisions in the school life as well as the surrounding community affecting it. The leadership in this regard does invite democratic deliberation on all issues and concerns brought before it as well as the decision making process and making it clear that participation is open, welcome and appreciated. They need to work to institutionalize structures, forums, and communication process that promote participation and act as a model by providing continuous training in deliberative process such as dialogue (p. 123). In a democratic community in school, leaders should possess the moral resolve to â€Å"promote democracy, empowerment, and social justice;† thus, should work on what he can contribute to the system rather than promote his self interest alone. Consistent with critical-humanist perspective of being a leader, and working in a democratic community in school, the leadership should commit in transforming society to its prominence in order to minimize, if not overthrow, the existing structures, process and power relationship that tend to minimize democratic practices (Furham & Starratt, 2002, p. 126). According to Furham & Starratt (2002), the constructivist leadership’s perspective work for the manifestation of the leadership practices within the relationship of a community and from the set up emerges to being real and vulnerable for each other thus engaging the participants into a real conversation. Finally, leadership in a democratic community in school is an art which the leaders engage in aesthetic and experimental behavior in designing a new school order. The conglomeration of these four leadership concepts—moral, critical-humanist, constructionist, and artistic—are the essence leadership behavior and roles in a democratic community in school. But above and beyond the four concepts, it is the art that â€Å"facilitates the construction of meaning within diversity aimed at the moral purpose of transforming schools into democratic communities† (p. 126-127). Finally, Furham and Starratt while considering democratic community as the center for educational leadership, gave the following claims: â€Å"[d]emocratic community is not a marginalizing center for the field because it is based on acceptance and appreciation of differences; [d]emocratic community recultures the profession by focusing on what leadership is for—serving the common good in multicultural society and world; and [d]emocratic community is the most appropriate focus for school leadership in the postmodern world of diversity, fragmentation and cross-nationalism† (p. 129). Societal and Community Barriers There are societal barriers and personal characteristics of leaders affecting the creation of a democratic community in school. The societal barriers and personal factors are hindrances that block a free exercise of the freedoms of choice and expression in the school set up leading to minimalist tendencies of democratic practices. The most apparent and strong force that hinder the democratic community in school’s effectiveness is the rules of business interest. Even if society’s concept of democracy does emphasize cooperation among its people, a lot of school has created an atmosphere of competition from grades, status, resources, programs, etc. Thus, even if these democratic educational institutions commit itself to credo more often than not they are aligned in a position of conflict with the dominant traditions of schooling. The democratic community in school’s ideas and efforts are resisted by institutions that benefit school’s inequities and those who are more interested in efficiency and hierarchical power than in the difficult work of transforming schools from the bottom up (Beane & Apple, 2002). The Realpolitik The revelation revealed by Furham and Starratt (2002) send a chill in the spine. According to them, the practice of democracy in schools and society â€Å"is governed by the rules of business interest† resulting to the shaping of school politics and curriculum leading to difficulty in enacting a â€Å"school that adheres to a democratic practice for to do so one has to overcome the rational/technical/instrumental assumption about schooling and learning shaped by business interest† over the last decades. They gave business assumptions about schooling, in the following: [t]he purpose of schools is instrumental—that is to serve national economic interest by preparing student for the work force; [t]he success of school in achieving this instrumental purpose can be rationally determined by measurable student achievement; [t]he individual’s motivation for learning in schools is instrumental—to succeed on individual measures of student achievement, in competition with other students, to secure financial prosperity; and [t]eaching is a technical problem and teachers/schools can be held accountable for measurable student achievement. As a result of the prevailing assumptions â€Å"about schooling, coupled with hierarchical, authoritarian traditions of school leadership, leadership for democratic community in schools requires opportunistic action at the local level as well as intentional and proactive leadership on the part of state and national leaders to affect policy directions† (p. 128) In the case of Brodhagen (2002), the challenge of creating a democratic community in school comes from her peers and from the prevalent system that operates in various schools. Her colleagues were the source of stress due to their lack of support and complete understanding to the visions and goals of having a democratic community in school. Opposition was centered on the fact that students were given freedom to choose their curriculum as well as the freedom of expression. Her colleagues were cautious in giving children these fundamental freedoms because they believe that only adults could exercise them; otherwise, it will lead to chaos and abuses. Though not setting up â€Å"roadblocks,† the leadership showed little support for the system by not inviting others to join. Finally, due to lack of textbooks and established curriculum, the initial curriculum planning was a â€Å"messy process† (p. 99) Ethical Rationale for Democratic School Leadership As a process, democratic leadership is a professional necessity for effective school governance due to a high diversified cultural communities and a new world order as a result of new technology and the forces of globalization. The professionalizing school’s democratic leadership should be made within the school leadership role’s nature, communities’ social context and the ideological social mandate. Begley & Johansson (2005) admits of the difficulty in many communities of achieving a democratic consensus on educational issues among even traditional educational stakeholders. The present social confusion along with diverse character stakeholders in the communities led to a perplexed attitude that in developing a prescriptive guide to ethical or value-added leadership there should be a list of standard norms for a school administrator to adopt without question. This quick fix method is not enough to respond to the demand needed in school leadership. A school leader must practice reflection and become an authentic in their leadership practices and the first step towards achieving this step is, predictably enough, to engage in personal reflection. The values perspective of school leadership is a tool that facilitate the reflection process as it transform a vague advice into a concrete thing for the school administrator to act upon. The process does not stop in reflection alone. Once the leader attained the required degree of improved self-knowledge via personal reflection, he must work towards an authentic leadership. That is, the leader must strive in developing his sensitivity to the values orientation of others (Begley & Johansson, 2005). The school leader’s ideas translated through his skills in transferring new pedagogical ideas and educational reforms to the teacher, teams of teachers and other key personnel among the staff. This transformation can be done through an organizational and leadership dialogue creating an understanding about the different reforms that will improve children’s learning on democratic society as well as the subject knowledge. An authentic professional leader shows active participatory dialogue with other school personnel including the school improvement agenda (Begley & Johansson, 2005). Begley & Johansson’s (2005) study listed down the different democratic and ethical vision of school leaders they need. The following: â€Å"a democratic and ethical leader sees a clear connection between work assignments, the national and local political goals, and the school’s operational philosophy. † In this area, the leader effectively communicates school goals and operational philosophy and â€Å"exercises leadership by translating operational philosophy into practical education tasks and by motivating the personnel and students to work towards the completion of these tasks. A democratic and ethical leaders also develops a value-informed sophistication in their practices to move beyond what Greenfield (1999) describes as the rhetoric of moral leadership. The new reality of school leadership is responding to value conflicts. This has become the defining characteristic of school leadership much like instructional leadership which was the dominant metaphor of school leadership during the 1980s. A number of implications are implied, including: understanding the problem of value articulation versus actual value commitment by individuals; the tendency towards ritual rationality in administration; the cultural isomorphs that are apparent in leadership practices; and finally the critical role dialogue plays in deepening an individual’s understanding of value position and motivational intentions, as well as ensuring genuinely democratic practice. At the very least, dialogical interactions have the potential to promote the thoughtful critique of current practices and better support the equitable and ethical resolution of value conflicts in education† (p. 16). After having listed the different visions and ethical dimensions of a leader, it is proper for us to review and examine the responsibilities attached to a leader in educational sector. In Starrat’s (2005) essay on â€Å"Responsible Leadership† advanced the concept that after having explored the wide terrain of ethical dimension of educational leaders â€Å"various domains of ethical responsibility are found. The term â€Å"domain† is used to refer to a constructed cluster of ethical concerns around common th

Kearlsey Case Study Essay

Tony Kearsley applies for a position as a firefighter with the City of St. Catharines and was accepted on condition that he were to pass a medical examination by a doctor specified by the city. However, during the medical exam the doctor discovered that Kearsley had an atrial fibrillation (an irregular heartbeat) and refused to pass him. Kearsley took it upon himself to consult a medical specialist who advised him that his condition would indeed not affect his ability to perform his job as a firefighter. Kearsley then filed a complaint against the city with the Ontario Human Rights Commission. At the Commissions Bored of Inquiry hearing, the doctor who had originally examined Kearsley testified that atrial fibrillation led to increased risk for stroke meaning his heart could fail to pump sufficient blood to his organs during the extreme conditions that come with firefighting. The Board of Inquiry called a medical expert in atrial fibrillation. The expert testified that the increased risk for stroke in someone of Kearsley’s age was inconsequential. The expert further testified that there was no increased risk for heart failure in someone like Kearsley because he was otherwise in good health. Meanwhile, after Kearsley got turned down by the St. Catharines fire department, Kearsley had become a firefighter in the City of Hamilton, achieving the rank of first-class firefighter in October 2001. 2. Why did the Board of Inquiry rule in Kearsley’s favour? The Board of Inquiry ruled in Kearsley’s favour because they came to the conclusion that Mr. Tony Kearsley had in fact suffered discrimination. The Board noted that it would have been the City of St. Catharines responsibility to seek an expert opinion when confronted with a medical condition such as that found in Kearsley. The Board also indicated that this was the procedure used in other municipalities. The City did not follow their responsibilities which led to Mr. Kearsley’s unfair treatment and discrimination based on disability. For these reasons, this is why I think the Board of Inquiry most definitely ruled in Kearsley’s favour. 3. Do you agree with the decision in this case? Why or why not? I strongly agree with the decision of the case. Tony Kearsley was without a doubt, discriminated based on disability which is illegal in Canada. I feel like the city of St. Catharines defiantly should have handled this matter in a more ordered and professional way, as it seems that none of the facts in favour of the city of St. Catharines truly added up. I feel like the city jumped to conclusions too quickly not taking into account that Tony Kearsley was still fully capable to fulfill all duties of a firefighter. They did not treat Mr. Kearsley as an equal after finding out he had a disability; this is an act of discrimination and this is illegal. The city of St. Catharines owes at the least these things to Mr. Tony Kearsley in return for their lack of knowledge towards him while doing their job. 4. In what ways in this case a question of human rights? This case is a question of human rights because it is strongly discriminating against disability in the workplace. The Ontario Human Rights Code provides in part: 5(1) Every person has a right to equal treatment with respect to employment without discrimination because of †¦ handicap. 10(1) â€Å"because of handicap† means for the reason that person has or had, or is believed to have or have had a) any degree of physical disability that is caused by illness. 17(1) a right of a person under this Act is not infringed for the reason only that the person is incapable of performing of fulfilling essential duties or requirements attending the exercise of the right because of handicap. It is obvious at once that a person with very bad eyesight is not discriminated against when refused a job as a truck driver nor a person with inadequate strength when refused a job as a police officer or firefighter. There is no doubt that St. Catharines considered that Mr. Kearsley had a physical disability, atrial fibrillation. The issue is whether St. Catharines was justified in concluding that because of this perceived disability; Mr. Kearsley was incapable of performing or fulfilling essential duties as a firefighter. It was later found out that Mr. Kearsley could indeed perform all duties as a firefighter, as he got hired by the City of Hamilton later that year. Therefore, Mr. Kearsley was discriminated against based on disability and this is without a doubt, a question of human rights.